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Antenatal visits and adverse perinatal outcomes: results from a British population-based study
Stavros Petrou1, Emil Kupek, Sarah Vause
1National Perinatal Epidemiology Unit, Institute of Health Sciences, University of Oxford, Old Road, Headington, OX3 7LF, Oxford, UK. stavros.petrou@perinat.ox.ac.uk
Objective:
The objective of this study was to explore the relationship between the number of antenatal visits made by a representative sample of British women and adverse perinatal outcomes.
Study Design:
A total of 20,771 women with a singleton pregnancy were recruited from nine representative maternity units in Northern England and North Wales. A record of each woman's antenatal care and the adverse perinatal outcomes of interest were extracted retrospectively from their case notes. Multivariate binomial regression was used to model the probability of adverse outcomes with respect to the absolute number of antenatal visits, after controlling for potentially confounding factors. Separate analyses were performed for primiparae and multiparae, and for low- and high-risk women within each parous group.
Results:
The study revealed an inverse association between the number of antenatal visits and delivery of a low birthweight infant, infant admission to a special care baby unit and perinatal mortality over the 4-14 antenatal visit range, which dissipated at higher levels of antenatal visits. The study also revealed a significant positive association between the number of antenatal visits and delivery by caesarean section (P<0.01). Similar trends in the probabilities of adverse outcomes were observed for low- and high-risk women within each parous group.
Conclusion:
Further experimental research is required to ascertain whether a causal relationship exists between antenatal visiting schedules and adverse perinatal outcomes.